NPIMap

Organization Active NPI

Cornerstone Pediatric Therapy Center, LLC

  • Pediatric Occupational Therapist
  • Bridgeport, WV
National Provider Identifier
1760616254
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
1175 Issued in WV
Legal business name
CORNERSTONE PEDIATRIC THERAPY CENTER, LLC
Practice address
231 Davis St
Bridgeport, WV 26330-1703
Phone
(304) 672-0077
NPI assigned
May 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrew R Citerone
Title
Member
Phone
(304) 672-0077

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X 1175 WV
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 1175 WV Primary

Addresses

Primary practice location

231 Davis St
Bridgeport, WV 26330-1703

Mailing address

PO Box 1276
Bridgeport, WV 26330-6276
Phone (304) 672-0077

Other names 1

  • Cornerstone Pediatric Center, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

231 Davis St
Bridgeport, WV 26330
Phone (304) 672-0077

387 Heliport Loop
Bridgeport, WV 26330
Phone (304) 842-0044

179 Hanalei Dr
#100
Morgantown, WV 26508

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1760616254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1276",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263306276",
            "telephone_number": "304-672-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 DAVIS ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301703",
            "telephone_number": "304-672-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE PEDIATRIC THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "CITERONE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "304-672-0077"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "WV",
            "license": "1175",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WV",
            "license": "1175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Pediatric Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.